Hkbu Kearny Myanmar Application Form 2009

Admissions Section, Academic Registry

For Office Use

HKID checked by:

Application Form for Admission to 2009-10 Kearny Journalism Scholarship Return applications no later than January 5, 2009 to [email protected] or PO Box 8, Mae Ping Post Office, Chiang Mai, 50301, Thailand.

Application Number

N08

Please submit the completed form with relevant supporting documents Part A Personal Data (Write in block letters.) Name

(Name on Passport)

Surname Other Names

中文姓名

Sex (M/F) Date of Birth

Passport No

year

Correspondence Address

Home Phone No. ____________________

month

day

Mobile Phone No. ____________________

Fax. No. ___________________

E-mail Address (An E-mail address must be provided as we may communicate with you via email) To facilitate interview arrangement, if any, please ‘ ’ this box if you are currently studying or residing overseas If you are a “non-local student”, please state your country of origin: Myanmar

√

(Non-local students are those who need to get hold of a student visa/entry permit issued by the Director of Immigration to enter Hong Kong for the purpose of education.)

Part B Choice of Degree Programmes (1. Masters of International Journalism Studies) Choice

Programme Title

First

Masters of International Journalism Studies

Part C

Study Year Apply For (Please tick one box only )

Part D

Applicant with a Disability (Please refer to Part D of Notes on Application for details.)

√

Year 1

Are you a student with a disability?

No

Yes

If yes, please indicate the nature of disability and attach supporting document that certifies your disability.

1

Part E

Category of Application (Refer to Part E of Notes on Application for details)

Please tick ( ) one category only which reflects the HIGHEST qualification you have attained; or you may tick put a ( ) beside “Mature Applicant” if you do not belong to any category below but are aged 25 or above on September 1, 2008. Graduated from a bachelor degree Completed third year of a bachelor degree Completed second year of a bachelor degree Completed first year of a bachelor degree Name of Institution: ___________________________________________

Graduated from a masters degree Name of Institution: ___________________________________________

Internationally accreddited high school qualification (such as GED, IGCSE) Mature Applicant (Parts H to I must be filled in)

Part F

Academic Qualifications & Examination Results

Please list details of your academic qualifications and examination results in chronological order in the following tables: 1.

2.

Secondary Education

Name of Secondary School and Country/ Region

Level Attended/ Attending

Post-Secondary Education

Name of College/University and Country/ Region

Level Attended / Attending

PT: part-time,

from

to

Period

Study Mode

(YYYY/MM)

(FT/PT/DL)#

from

# FT: full-time,

Period

(YYYY/MM)

to

DL: distance-learning

2

Qualifications Obtained/To be Obtained (GED, GCSE/IGCSE/GCE, IB and other public exam results)

Programme Duration

(Please state no. of years)

Programme Title & Major Study e.g. Associate of Arts – Business

Latest Cumulative GPA / Average Score

Which programme concentration are you applying for? (tick one) ____ Concentration in International Journalism ____ Concentration in Business and Financial Journalism

3.

Public Examinations Results

c.

International Examinations such as GED, IB, IGCSE Examination

d.

Year of Attempt

Country/ Region

Other English Language Qualifications

Examination TOEFL

Year of Attempt

Paper -based

Subjects Taken and Grades

Score Computer -based

Examination Internet -based

IELTS (Academic Level)

3

Others (Please specify)

Year of Attempt

Score / Grade

Part G

Other Academic/Professional Qualifications

Professional Body and Country

Part H

Name of Award / Qualification / Examination

Level/Grade

Date of Award

Working Experience (Including Full-time, Part-time and Relevant Voluntary Work)

(Only applicants applying under the category “Mature Applicant” are required to provide supporting documents on working experience at this stage.)

Date

(YYYY/MM)

from

Part I

Name of Organization

Post

Duties

to

Full-time/ Part-time/ Voluntary

Additional Information (Please provide information which may be helpful to your application, such as reasons for application, career aspiration, personal strengths, hobbies and interests, voluntary services, etc. separate sheet if necessary.)

Use

Please attach the following documents: 1. Copies of all educational transcripts including official English test scores. 2. A 500 word statement in English outlining your academic interests and objectives and your future plans. If available, also attach a sample piece of journalism and/or research paper.

Part J 1. 2. 3. 4.

Declaration (Please do not delete any item of this part)

I declare that the information given above in support of my application is accurate and complete to the best of my knowledge. I understand that such information will be used as a basis for selection for admission to the graduate programmes and other related or relevant purposes and that any misrepresentation will disqualify my application for admission and enrolment in the University. I authorize the University to use my data to carry out checks on multiple applications and records of previous studies in various institutions/schools. I understand that, upon successful outcome of my application, the relevant data will become a part of my student record and may be used for all purposes relating to my study in accordance with the procedures of the University. I authorize the University to obtain, and the relevant examination authority or academic institution in Hong Kong or elsewhere to release, information about my public examination results, records of studies or professional qualifications, if deemed appropriate.

Signature

Date

4